Among 576 cases of herpes zoster in patients of all ages, 31 (5.4%) occurred in children under 15 years of age. The factors of race, sex, season, and laterality revealed no imbalance when compared to previous studies. The thoracic segments and the trigeminal nerve were most commonly affected. Involvement of a single dermatome was distinctly unusual in patients with extracranial herpes zoster. "Zoster sine neuralgia," a clinical variant not previously emphasized, was described. The benign clinical course of herpes zoster in most children and the varied severity of the illness in children with an associated malignancy was discussed. An additional case of herpes zoster occurred in a renal allograft recipient. The host defense mechanisms to herpes zoster were discussed. Four hypotheses were offered to explain the clinical picture of herpes zoster.